The shoulder joint, also known as the glenohumeral joint, is a ball and socket synovial joint between the head of the humerus and the glenoid cavity of the scapula. It has a wide range of motion but lacks stability. The joint is surrounded by ligaments including the joint capsule, coracohumeral ligament, and glenohumeral ligaments. Accessory structures include bursae that reduce friction, such as the subacromial bursa. Common motions are flexion, extension, abduction, adduction, and rotation. Injuries include dislocations and rotator cuff tendonitis from overuse.

1. Shalini Gupta
Diploma in
Physiotherapy
Shoulder Joint
Glenohumeral Joint

2. SHOULDER JOINT
The Glenohumeral Joint is
Synovial ball and socket articulation
–Between
•
•
•
•
It is
The
The
the
head of the humerus and
glenoid cavity of the scapula.
major joint connecting the upper
the trunk.
•
limb to

3. SHOULDER JOINT
SHOULDER JOINT is component of SHOULDER
which comprises of five linkages.
GIRDLE
1.
2.
Glenohumeral
Suprahumeral articulation:
• Coracoacromial arch above with head
with subdeltoid bursa in between.
of humerus below
3.
4.
5.
Acromioclavicular
Sternoclavicular
Scapulothoracic (muscular)

5. TYPE
• The shoulder joint is a ball-and-socket
type of synovial joint.
•
•
The head of humerus
The glenoid cavity of
socket.
is the ball.
the scapula is
–A dense fibrocartilagenous lip, called
labrum glenoidale is attached to the rim
the glenoid cavity and makes it wider &
deeper.
of

6. SHOULDER JOINT
The shoulder joint has the following
characteristics.
It has a very wide range of movements.
•
•
–The shoulder joint is
joint of the body.
It is not a stable or a
–It is most commonly
in the body.
the most movable
• secure joint.
dislocated large joint

8. LIGAMENTS
The ligaments of the shoulder joint are as follows:
1. Capsular ligament (joint capsule):
2. Glenohumeral ligaments: There are three thickenings
the anterior part of the fibrous capsule; to strengthen it.
•
•
• in
–
–
–
Superior ,
Middle ,
Inferior glenohumeral ligaments.
• 3. Coracohumeral ligament: It is a strong band of fibrous
tissue that passes from the base of the coracoid process to
the anterior part of the greater tubercle of the humerus.
• 4. Transverse humeral ligament: It is a broad fibrous band,
which spans the bicipital groove between the greater and
lesser tubercles changing it the groove into a canal.
– It provides passage to the tendon of long head of biceps
surrounded by a synovial sheath.

10. ACCESSORY LIGAMENTS
Coracoacromial ligament: It extends between
1.
coracoid and acromion processes. It protects the
superior component of the joint.
Coracoacromial arch: The coracoacromial arch is
formed by coracoid process, acromion process,
and coracoacromial ligament between them.
•
– This strong triangular band forms a protective arch for
the head of humerus above and prevents its superior
displacement above the glenoid cavity.
The supraspinatus muscle passes under this arch and
exists deep to the deltoid where its tendon mixes with
the joint capsule.
–

12. The joint capsule
The joint capsule is a fibrous sheath which encloses
the structures of the joint.
It extends from the anatomical neck of the
humerus to the border of the glenoid fossa.
The synovial membrane lines the inner surface of
the joint capsule, and produces synovial fluid to
reduce friction between the articular surfaces.
•
•
•
• Several synovial bursae are present.
– A bursa is a synovial fluid filled sac, which acts as a
cushion between tendons and other joint structures.

14. Joint capsule
The synovial cavity of the joint shows the
following features:
–It forms tubular sheath around the tendon
of biceps brachii where it is located in the
bicipital groove of the humerus.
–It communicates with subscapular and
infraspinatus bursae, around the joint.
Thus there are three apertures in the
joint capsule.
•
•

15. Three apertures in the joint capsule
1. An opening between the tubercles of the
humerus for the passage of tendon of long
head of biceps brachii.
An opening located anteriorly inferior to
the coracoid process to allow interaction
between the synovial cavity and
subscapular bursa.
2.
3. An opening located posteriorly to
communication between synovial
and infraspinatus bursa.
allow
cavity

17. BURSAE RELATED TO THE SHOULDER JOINT
Subscapular bursa:
– It lies between the tendon of subscapularis and the neck of
the scapula; and protects the tendon from friction from the
neck. This bursa normally communicates with the joint cavity.
Subacromial bursa:
– lies between the coracoacromial ligament and acromion
process above, and supraspinatus tendon and joint capsule
•
•
below. It continues downwards beneath the deltoid, hence
is sometimes also described as subdeltoid bursa.
It is the biggest synovial bursa in the body.
Infraspinatus bursa:
– It lies between the tendon of infraspinatus and
posterolateral aspect of the joint capsule. It may sometime
communicate with the joint cavity.
it
•

19. Important Relations
•The subscapularis muscle
•Deltoid
•The axillary vessels and brachial plexus
Anteriorly
•The infraspinatus
•Teres minor muscles
Posteriorly
•The supraspinatus muscle,
•Subacromial bursa,
•Coracoacromial ligament,
•Deltoid muscle
Superiorly
•The long head of the triceps muscle,
•The axillary nerve
•The posterior circumflex humeral
vessels
•The tendon of the long head of the
biceps muscle passes through the joint
and emerges beneath the transverse
ligament
Inferiorly

20. Neurovascular Supply
Arterial supply to the glenohumeral joint is via
– The anterior and posterior circumflex humeralarteries, and
– The suprascapular artery.
•
• Branches from these arteries form
the joint.
The joint is supplied by:
an anastomotic network around
•
–
–
–
The axillary,
The suprascapular and
The lateral pectoral nerves.
• These nerves are derived from roots C5 and C6 of the brachial
plexus.
– An upper brachial plexus injury (Erb’s palsy) will affect shoulder joint
function.

22. Movements at the shoulder
• Two types of movements:
1. Movements of the shoulder joint:
– Take place between humerus &
scapula
2. Movements of the shoulder girdle:
–Involve clavicle & scapula together and
occur at the shoulder joint

23. Movements of the shoulder joint
Anterior fibers of the deltoid
Posterior fibers of the deltoid
Deltoid middle fibres (up to 90⁰)
Teres major
Abduction Supraspinatus (up to 15⁰)
Trapezius & serratus anterior(above head)
Adduction Pectoralis major
latissimus dorsi
Coracobrachialis
Subscapularis
flexion Pectoralis major(clavicular head)
Coracobrachialis
Biceps
Extension Pectoralis major(sternocostal head)
Teres major
Latissimus dorsi

24. Movements of the shoulder joint
Teres major
Teres minor
movement of a limb that includes flexion,
Circumduction Circumduction is a cone-shaped
abduction, extension, and adduction.
Medial rotation Pectoralis major
Latissimus dorsi
Anterior fibers of the deltoid
Subscapularis
Lateral rotation Infraspinatus
Posterior fibers of the deltoid

25. D
Elevation
Shoulder
Girdle
Movements
Abduction
Adduction
epression

26. Movements
• Elevation
– Upward or superior
movement,
shoulders
as in shrugging
• Depression
– Downward
movement,
or
as
inferior
in returning to
normal position

28. Movements
• Abduction (protraction)
– Scapula moves laterally away
from spinal column
• Adduction (retraction)
– Scapula moves medially
toward spinal column

30. Movements
• Upward rotation
– Turning glenoid fossa upward &
moving inferior angle
superolaterally away
column
from spinal
• Downward rotation
– Returning inferior angle
inferomedially toward spinal column
& glenoid fossa to normal position

31. Glenoid faces down Glenoid faces up

32. Movements of the shoulder girdle
Upward rotation(glenoid faces up) Lower Trapezius
Upper Trapezius
Serratus Anterior(lower part)
Downward rotation Levator Scapula
(glenoid faces down) Rhomboids
Latissimus Dorsi
Protraction (pulling forwards) Serratus Anterior
Pectoralis Minor
Retraction (pulling backwards) Middle Trapezius
Rhomboids
Elevation(shrugging shoulders) Upper Trapezius
Levator Scapula
Depression(drooping shoulders) Pectoralis Major
Pectoralis Minor
Latissimus Dorsi

33. Mobility and Stability
The shoulder joint is one of the most mobile in the body,
the expense of stability.
Factors that contribute to mobility:
• at
•
–Type of joint – It is a ball and socket joint.
–Bony surfaces – Shallow glenoid cavity and
large humeral head
• There is a 1:4 disproportion in surfaces.
–Laxity of the joint capsule.

34. Mobility and Stability
• Factors that contribute to stability:
–Rotator cuff muscles:
–Glenoid labrum:
–Ligaments:
•The ligaments act to reinforce the joint
capsule, and forms the coraco-acromial
arch.

36. Clinical Relevance: Common Injuries
Dislocation of the Shoulder Joint:
– Dislocations at the shoulder are described by where
the humeral head lies in relation to the infraglenoid
tubercle.
An anterior dislocation is usually caused by
excessive extension and lateral rotation of
the humerus. The humeral head is forced
•
•
anteriorly and inferiorly
the joint capsule.
into the weakest part of
• The axillary nerve runs in close proximity to the
shoulder joint, and can be damaged in the
dislocation. Injury to

37. CLINICAL CORRELATION
• A portion of epiphyseal line
proximal humerus is
intracapsular,
of
• Septic arthritis of the shoulder
joint may occur following
metaphyseal osteomyelitis.

38. Rotator Cuff

39. Rotator Cuff Tendonitis
Tendonitis refers to inflammation of the muscle
tendons – usually due to overuse. This may
cause degenerative changes in the subacromial
bursa, and the supraspinatus tendon.
– This increases friction between the structures of the
joint.
The characteristic sign of rotator cuff tendonitis is
the ͚painful arc͛ – pain in the middle of abduction,
where the affected area comes into contact with
the acromion.
•
•

40. Subacromial bursitis,
supraspinatus
tendinitis, or
pericapsulitis showing
the painful arc in the
middle range of
abduction, when the
diseased area impinges
on the lateral edge of
the acromion.